TY - JOUR
T1 - Evaluation and management of acute high-grade immunotherapy-related neurotoxicity
AU - Sandoval, Marcelo
AU - Wechsler, Adriana H.
AU - Alhajji, Zahra
AU - Viets-Upchurch, Jayne
AU - Brock, Patricia
AU - Lipe, Demis
AU - Al-breiki, Aisha
AU - Yeung, Sai Ching J.
N1 - Funding Information:
The authors thank Ann M. Sutton from the Research Medical Library at The University of Texas MD Anderson Cancer Center for editing this manuscript, and Kate J. Krause, Senior Librarian, for the literature search.
Publisher Copyright:
© 2023
PY - 2023/3
Y1 - 2023/3
N2 - Immune checkpoint inhibitor monoclonal antibodies allow the host's immune system to attack tumors, which has revolutionized cancer care over the last decade. As the use of immune checkpoint inhibitors has expanded, so have autoimmune-like complications known as immune-related adverse events. These include the infrequent but increasingly more common, potentially deadly neurological immune related adverse events. When feeling acutely ill, patients will often seek care not from their oncologist but from their family physician, clinics, emergency, and urgent care sites, or other available providers. Thus, while assessing acutely ill cancer patients who are experiencing neurological symptoms, non-oncologists should be prepared to recognize, diagnose, and treat neurological immune related adverse events in addition to more familiar conditions. This narrative review is designed to update acute care clinicians on current knowledge and to present a symptom-based framework for evaluating and treating neurological immune related adverse events based on the leading immunotoxicity organizations' latest recommendations.
AB - Immune checkpoint inhibitor monoclonal antibodies allow the host's immune system to attack tumors, which has revolutionized cancer care over the last decade. As the use of immune checkpoint inhibitors has expanded, so have autoimmune-like complications known as immune-related adverse events. These include the infrequent but increasingly more common, potentially deadly neurological immune related adverse events. When feeling acutely ill, patients will often seek care not from their oncologist but from their family physician, clinics, emergency, and urgent care sites, or other available providers. Thus, while assessing acutely ill cancer patients who are experiencing neurological symptoms, non-oncologists should be prepared to recognize, diagnose, and treat neurological immune related adverse events in addition to more familiar conditions. This narrative review is designed to update acute care clinicians on current knowledge and to present a symptom-based framework for evaluating and treating neurological immune related adverse events based on the leading immunotoxicity organizations' latest recommendations.
KW - Diagnosis
KW - Emergency department
KW - Immune checkpoint inhibitors
KW - Immune-related adverse effects
KW - Management
KW - Nervous system
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U2 - 10.1016/j.heliyon.2023.e13725
DO - 10.1016/j.heliyon.2023.e13725
M3 - Review article
C2 - 36851967
AN - SCOPUS:85149068531
SN - 2405-8440
VL - 9
JO - Heliyon
JF - Heliyon
IS - 3
M1 - e13725
ER -